Teachers Cry Foul as SHA Medical Cover Fails to Deliver on Promise

What was expected to be a smooth transition to improved healthcare has instead turned into a frustrating ordeal for many Kenyan teachers.

Just two months after moving from their long-standing medical insurer, Minet, to the newly established Social Health Authority (SHA), teachers are raising serious concerns over access to medical services. 

The change followed intense negotiations and a high-stakes agreement meant to guarantee better coverage and easier access to healthcare.

However, the reality on the ground has been far from the promise.

Despite being officially registered as beneficiaries, many teachers report being turned away from hospitals or forced to pay cash for services that should be fully covered under SHA. This has left educators struggling to meet medical expenses out of pocket.

The Kenya Union of Post Primary Education Teachers (KUPPET) has sounded the alarm, saying its members are effectively paying twice — first through mandatory deductions and again at hospital reception desks.

While SHA was introduced to create a more inclusive and efficient system, its implementation has left many teachers stuck in uncertainty. For educators seeking medical care, being asked to pay cash despite having active cover feels like a betrayal of the agreement reached late last year.

According to KUPPET, the challenges stem from several key issues:

Administrative delays, particularly slow synchronization between former insurance providers and the SHA database.

Facility hesitation, with some private hospitals reluctant to offer services due to concerns over delayed reimbursements.

System downtime, as frequent technical glitches prevent real-time verification of beneficiaries.

KUPPET Chairman Amboko Milemba has urged the Ministry of Health to move beyond excuses and urgently address the operational failures undermining the scheme. 

He stressed that teachers should not be denied emergency or routine care because of technical or administrative shortcomings.

“For teachers in the classroom, the technical explanations don’t matter,” union officials say. “What matters is knowing that when illness strikes, the system they pay into will work.”

Until SHA bridges the gap between policy announcements and hospital-level implementation, Kenya’s teachers remain trapped in a costly and stressful waiting game, uncertain whether their medical cover will come through when they need it most.